"Taking their tonsils and adenoids out didn't really change the incidence or the amount of time they spent with infected ears," says Dr. Richard Kaplan of University Physicians.
The study showed benefits during first year after surgery, but those benefits did not last. Dr Kaplan says surgery should only be considered after antibiotics, allergy testing and tubes have failed.
"Given that we found both operations to have limited efficacy and in view of their not inconsiderable risks, morbidity and costs, we believe that neither operation ordinarily should be considered as an initial intervention" in children with chronic middle ear infections, the report from Children's Hospital in Pittsburgh said.
"Instead we believe that nonsurgical management should be attempted first, with tube placement to be considered later as the preferred first surgical recourse if the burden of illness becomes intolerable," it added.
After that, adenoid removal should be considered in cases where middle ear infections continue despite the use of ear tubes, it said.
The study, published in the Journal of the American Medical Association, was based on a look at 461 children aged three to 15. Some underwent surgery to remove adenoids, others both adenoids and tonsils and others had no surgery.
The report concluded that surgery offered only modest help against otitis media -- the middle ear inflammation that affects one in every six children in the first year of life and often remains common through childhood.
"This new study will at least help parents ask the questions as to whether it is a worthwhile thing to do," Dr. Kaplan said.
Removal of tonsils, adenoids or both is the most commonly performed major surgical operations among U.S. children, according to the article, with 420,000 children under the age of 15 undergoing such operations in 1994. Doctors often perform the surgery to not only relieve kids of ear infections but also sore throats and stuffy noses.
The authors said the primary or secondary surgical diagnosis underlying many such surgeries is otitis media.